Pustulosis palmaris et plantaris

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Pustulosis palmaris et plantaris
Other names: Pustulosis of palms and soles,[1] Palmoplantar pustulosis, Persistent palmoplantar pustulosis, Pustular psoriasis of the Barber type, and Pustular psoriasis of the extremities
Pustular Psoriasis.jpg
Pustulosis palmaris et plantaris
Risk factorsSAPHO syndrome

Pustulosis palmaris et plantaris is a chronic recurrent type of localized pustular psoriasis on the palms and soles only, characterized histologically by intraepidermal pustules filled with neutrophils.[2]: 411, 628 [3]

It can occur as part of the SAPHO syndrome.[4]


Systematic reviews show evidence to support the use of systemic retinoids alone and in combination with photochemotherapy to improve symptoms of chronic palmoplantar pustulosis, with a combination more effective than one alone. There is also evidence to support topical steroids under hydrocolloid occlusion dressings, low dose ciclosporin, tetracyclines, and Grenz-Ray Therapy. There is no evidence to support the use of hydroxyurea in chronic palmoplantar pustulosis.[5]

Treatment with guselkumab, an anti–interleukin 23 monoclonal antibody has shown a decrease in the size of the area affected and severity.[6]

Additional images

See also


  1. Rapini RP, Bolognia JL, Jorizzo JL (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
  2. Freedberg IM, Fitzpatrick TB (2003). Fitzpatrick's Dermatology in General Medicine (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
  3. James, William D.; Elston, Dirk; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac (2020). "10. Seborrheic dermatitis, psoriasis, recalcitrant palmopustular eruptions, pustular dermatitis, and erythroderma". Andrews' Diseases of the Skin: Clinical Dermatology (13th ed.). Edinburgh: Elsevier. pp. 203–204. ISBN 978-0-323-54753-6. Archived from the original on 2022-06-04. Retrieved 2022-06-02.
  4. Matzaroglou C, Velissaris D, Karageorgos A, Marangos M, Panagiotopoulos E, Karanikolas M (November 2009). "SAPHO Syndrome Diagnosis and Treatment: Report of Five Cases and Review of the Literature". The Open Orthopaedics Journal. 3: 100–6. doi:10.2174/1874325000903010100. PMC 2790148. PMID 19997538.
  5. Chalmers, Robert; Hollis, Sally; Leonardi-Bee, Jo; Griffiths, Christopher EM; Marsland Bsc MRCP, Alexander (2006-01-25). "Interventions for chronic palmoplantar pustulosis". Cochrane Database of Systematic Reviews (1): CD001433. doi:10.1002/14651858.cd001433.pub2. ISSN 1465-1858. PMID 16437433.
  6. Terui T, Kobayashi S, Okubo Y, Murakami M, Zheng R, Morishima H, et al. (July 2019). "Efficacy and Safety of Guselkumab in Japanese Patients With Palmoplantar Pustulosis: A Phase 3 Randomized Clinical Trial". JAMA Dermatology. 155 (10): 1153. doi:10.1001/jamadermatol.2019.1394. PMC 6613288. PMID 31268476.

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